La El Hage

Introduction to Medicine
Teacher: Mr. Hemal Bosamia

January 27, y

The Evolution Of Cancer

Surgery

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TABLE OF CONTENTS:
1. Why I have chosen this topic.
1. Why is it important?
2. Introduction.
3. How has its use and relevance changed over the years.
-The discovery of cancer surgery.
-The first radical mastectomy.
-The role of technology in cancer surgery.
4. What might happen in the future to the procedure?
6. Conclusion.

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1.Why have I chosen it?

On our trip to the Hunterian Museum, the cancer surgery section was
the one that grabbed my attention. I have chosen this particular topic, for
one main reason, being the fact that surgical oncology is one of the medical
fields I am considering as a career. With its evolution and progress over the
years, that has been remarkable and very interesting, cancer surgery has
much more potential and might be the cure for the disease.
2.Why is it important?
Cancer surgery is a procedure used to remove a tumor, an abnormal
growth of tissue in the body, that causes swelling. It could be the only
treatment a patient diagnosed with cancer has to go through, depending on
the location of the tumor and if it has spread. It saves many people
diagnosed with the disease, and can definitely eliminate cancerous cells if
the tumor is removed. As a matter of fact, the procedure has come a long
way since, with the help of many scientific discoveries that have since been
brought to light as well as the evolution of technology in medicine.
3.Introduction:
Cancer is a disease caused by an abnormal division of the cells that go
on to form a tumor1. It is believed to be caused by many factors including
modifiable ones (smoking, alcohol, gender) and non modifiable ones

1https://www.google.co.uk/webhp?

hl=en&ictx=2&sa=X&ved=0ahUKEwjVkJeC7q3OAhXDI8AKHamsA8YQPQgD#safe=strict&hl=en&q=canc
er+definition

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(family history of cancer). In the Uk, approximately 160 000 people die of
cancer yearly. However, it is in some cases curable due to many treatments,
including cancer surgery.

4.How has its use and relevance changed over the years
-The discovery of cancer surgery:
The surgical operation was discovered by the ancient Egyptians and
dates back to 3000 BC. It is revealed in a textbook where 8 tumors or ulcers
of the breast were removed with a fire drill. The greek doctor Galen and the
physician Hippocrates, viewed cancer as an incurable disease and this theory
was used for a couple of centuries.
However, scientists of the 15th century including Leonardo Da Vinci,
started understanding the human body and the way it works. In the 17th
century, astronomer Galileo and physicist Newton started using the scientific
method, that consists in observation, measurement and experiments. John
Hunter, a famous Scottish surgeon contributed his life to dissection, and
therefore, after many experiments discovered that if the tumor could move
in the body, it should be removed.
With the innovation of anesthesia in 1846, and its first successful use by
Karl Koller in 1859 through the isolation of cocaine, classic cancer surgeries
such as mastectomies (removal of a breast or two to treat breast cancer)
were developed. The next century was named the century of the surgeon 2.

2http://www.cancer.org/acs/groups/cid/documents/webcontent/002048-pdf.pdf

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-The first mastectomy and cancer theories:

In the 19th century, the Four Founding Physicians of the John Hopkins
University, American surgeon William Halsted, pathologist William Welch,
internist William Osler, and gynecologist Howard Kelly made many
discoveries in the scientific field. But Halsted played a particular role in the
evolution of cancer surgery. The surgeon developed the first radical
mastectomy, in which he managed to remove a lymph that caused breast
cancer. He believed that cancer was curable if removed, and that it did not
spread through the bloodstream. Along came Handley and Bilroth, two
scientists that believed cancer grew outwards from the original growth.
Stephen Paget (1855-1926), an English surgeon, contradicted Halsteds
theory, saying that cancerous cells do in fact spread through bloodstream.
His breakthrough allowed doctors in the future decades, to develop what
would now be the cancer treatments used.

-Technology in cancer surgery:

In the end of the 20th century, doctors invented a technique to reduce
the amount of normal tissue removed during cancer surgery. Moreover,
progress was also made in a way that bones and soft tissue tumor were
removed from the arms and legs without amputation.
In the 1970s, exploratory surgery was necessary to discover cancer.
Imaging tests (ultrasounds, CT scans and MRI scans) were discovered to
decrease the use of the now useless exploratory surgery.
Today, surgeons use specific tools powered by fiberoptic technology to
perform the procedure. They also use video cameras to observe what is
happening internally (endoscopy). Therefore, small surgical instruments can
be used to access tubes inside the body.

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5.What might happen in the future?

Over and above, new and various procedures are being discovered, per
example: cryosurgery (freezing and killing the abnormal cells with liquid
nitrogen) and lasers that are now replacing scalpels to cut into the skin.

References:
http://www.cancer.org/acs/groups/cid/documents/webcontent/002048pdf.pdf
http://www.cancerresearchuk.org/health-professional/cancerstatistics#heading-One
http://www.cancercenter.com/colorectal-cancer/statistics/tab/coloncancer-survival-statistics/
https://en.wikipedia.org/wiki/Anesthesia
http://www.hopkinsmedicine.org/about/history/history5.html

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